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General NPI Number Information
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NPI Number | 1831425396
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Entity Type | Individual
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Provider Name | PAMELA ROCHELLE SHADAIA LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | G3200 BEECHER RD STE MBI
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City | FLINT
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State | MI
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Zip | 48532-3613
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Country | US
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Telephone | 810-342-5470
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Fax | 810-342-5788
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Provider Business Mailing Address
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Address Line | 4473 DANIEL DR
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City | GRAND BLANC
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State | MI
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Zip | 48439-7653
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Country | US
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Telephone | 248-894-5683
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Fax | 773-866-8014
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801090202
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License Number State | MI
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